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September 14, 1935


JAMA. 1935;105(11):871-873. doi:10.1001/jama.1935.02760370027011

Although angina pectoris has been recognized for nearly two centuries, its pathologic physiology continues to be obscure. Whatever theory is subscribed to, whether the coronary, the aortic or the myocardial, it is generally agreed that the actual attack is precipitated by a demand on the heart which for one reason or another cannot be met.

Keefer and Resnik1 have proposed on excellent theoretical and factual grounds that anoxemia of the myocardium, however brought about, is the fundamental pathologic condition.

In the past few years I have had occasion to see a number of patients whose presenting complaint was typical angina or attacks indistinguishable from it. Further studies of these cases have revealed various constitutional diseases, the adjustment of which has either improved or done away with the anginal attacks. This relief allows of some interesting speculations on the cause of angina.

In the following case reports, data that have

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